So
why are so many
diagnoses of this condition mistaken? The primary culprit is non-specific clinical
decision-making, compounded by a failure to understand correctly the workings
of the musculoskeletal system. Carpal tunnel syndrome is a specific diagnosis
which involves mechanical pressure on spinal nerves in the neck and the median
nerve as it passes through a small tunnel in the wrist created by tiny
adjoining bones. There's not much room in this carpal tunnel and its dimensions
can be narrowed further by repetitive stress and inflammatory conditions such
as osteoarthritis or rheumatoid arthritis. Pregnancy can lead to carpal tunnel
syndrome owing to increased fluid retention. Repetitive postural stress may
lead to inflammation of tendons that cross the wrist. Such inflammation may
lead to soft tissue swelling which compresses the carpal tunnel, causing carpal
tunnel syndrome.
Importantly, carpal tunnel syndrome
is not a catchall diagnosis to be used when a person has forearm, wrist, and/or
hand pain. If a person really has carpal tunnel syndrome, he or she will have
specific symptoms. The person will awaken at night owing to pain, numbness and/or
tingling. Symptoms will be precisely located to the thumb and index finger
(possibly involving the middle finger). Wrist pain may or may not be present.
Also, the person will demonstrate a weakness of pinch grip involving the thumb
and index finger. If these signs and symptoms are not present, the person does
not have carpal tunnel syndrome. Usually, the diagnosis is clear-cut and does
not require special tests such as electromyography.
Remarkably, most physicians are
unaware of these important criteria. Most the time a patients diagnosis is as
follows if the patient has pain/or numbness in the hand, the patient has carpal
tunnel syndrome. Case closed. This lack of sophistication leads to real harm
done to the patient, such as unnecessary time wasting tests which can cost a
lot of money, and may result in damaging surgery. If carpal tunnel syndrome is
not present this specific surgery is not curative because it’s a solution for a problem that isn’t actually there. A carpal tunnel syndrome diagnosis should only be
determined by a highly trained professional with accurate analysis of
musculoskeletal problems involving the shoulder, arm, and hand (such as a well-trained
chiropractor).
Carpal
tunnel syndrome is a double crush problem, meaning that the neck and the wrist
are both involved. At Chiropractic USA we use our broad knowledge and
experience to correctly evaluate the situation on patients that are present
with symptoms mimicking those of carpal tunnel syndrome. For example, spinal
dysfunction, muscle spasm, and trigger points can all cause symptoms which
appear to be those of carpal tunnel syndrome. Before a permanent surgery is
performed conservative chiropractic adjustments of the wrist and neck, and
postural corrective procedures should always be the first choice of treatment.
If you feel you may have carpal tunnel syndrome, or if you have been recently diagnosed… do your research and make an informed decision!
Tip: check out our video post on
energy exercising to increase daily blood flow to your hands and wrists. ( http://www.applestozen.blogspot.com/2012/10/more-energy-in-just-5-minutes.html)
Uchiyama
S, et al: Current concepts of carpal tunnel syndrome: pathophysiology,
treatment, and evaluation. J Orthop Sci 15(1):1-13, 2010
Bialosky JE, et al: Heightened pain sensitivity in individuals with signs and symptoms of carpal tunnel syndrome and the relationship to clinical outcomes following a manual therapy intervention. Man Ther 16(6):602-608, 2011
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